Diagnostic sensitivity of electrophysiology and ultrasonography in ulnar neuropathies of different severity

ObjectiveTo assess the diagnostic performance of electrophysiology and nerve ultrasound in ulnar neuropathies of varying clinical severity in 135 consecutive patients.MethodsClinical severity of ulnar neuropathy was graded on a 4 point scale from very mild (symptoms only) to severe (marked atrophy of intrinsic hand muscles). Sensitivity and localization ability of electrophysiology and nerve ultrasound were assessed for each point of the scale.ResultsUltrasound had higher sensitivity than electrophysiology in clinically very mild (20% and 3% for ultrasound and electrophysiology, respectively) and mild (62% and 47% for ultrasound and electrophysiology, respectively) neuropathies, had greater localizing ability in axonal ulnar neuropathies, and identified nerve hypermobility.Ultrasound nerve cross-sectional area had strong positive correlation with both clinical and electrophysiological severity scores, but with significant overlap across the severity groups.ConclusionThe diagnostic work-up of ulnar neuropathies was improved by using both electrophysiology and ultrasound at all levels of clinical severity. Ultrasound increased the diagnostic yield in very mild and mild neuropathies, localized all the ulnar neuropathies with abnormal non-localizing electrophysiology and identified nerve hypermobility.SignificanceThis is the first detailed analysis of the diagnostic performance of electrophysiology and ultrasound in ulnar neuropathies of varying severity.     

Wrong tooth extraction: further analysis of “never event” data

The NHS in England requires the reporting of defined “never events” that are directly related to patients’ safety. Analysis of data from 2012–2015 has been published previously in this journal. An examination of continuing data from 2015–2019 shows that “wrong tooth/teeth removed” has not reduced in frequency and it still remains a common “wrong-site surgery” event accounting for between 16% and 24% of wrong-site surgery never events and 7%–10% of all never events reported. Hospitals and community Trusts remain the main source of such reports, although some now originate from primary-care-based dental settings. Further efforts have focused on prevention, and the implementation of existing measures to reduce the risk of wrong tooth extraction, is warranted.     

手术患者“边缘时间”的安全护理

现代医院手术室每日接待大量的手术患者,虽然都已经认识到各种风险的存在,但往往把目光集中在手术间内,而容易忽略手术前、后病人在转运过程“边缘时间”的安全。文章总结、分析了以往手术前后“边缘时间”存在的风险,设置了合理的接送程序;使用患者身份识别腕带的“五查对制度”;采取搬运患者前的“一查、二看、三整理、四搬运”等护理对策。     

Evidence-based Medicine

Summary:  Evidence-based medicine (EBM) has become a watchword for "the new" medical practice in the new century. Whether it represents a paradigm shift or simply a codification of the scientific method in medicine will be debated for years to come. Regardless of the place of EBM in medicine, this "movement" has served an important role in moving physician practice into the realm of becoming more scientific (albeit empirical) and transparent. There are still many problems to be addressed in the global application of the best evidence for medical practice. These include low-quality studies, delays in implementation of clear-cut improvements, outright fraud and deceit, and wariness on the part of physicians to change their practice. By working to understand the underpinnings of EBM (basic statistical concepts and critical thinking) we can advance the practice of medicine along the moral high road of science.     

Concerns for medical radiation programs in Australian universities

The Australian higher education system is in a state of great change. The Federal education minister, Dr Brendan Nelson, has indicated that he intends to continue introducing far-reaching reforms that will impact significantly on how universities conduct teaching and research. The future allocation of government funding for university programs, including those in medical radiation, will have a significant effect on how those programs are delivered and could even determine whether programs remain viable. There will be a financial imperative for academic departments to strengthen research activity and to obtain funding from non-government sources, such as full-fee paying students, in order to generate enough income to cover program delivery. Medical radiation education in Australia is also facing many other challenges. Some of these are longstanding, such as the high cost of medical radiation program delivery, poor levels of research activity and difficulty in recruiting and retaining academic staff. Other problems have arisen recently, such as increased competition for students and a critical shortage of available training placements in clinical practice. The aim of this paper is to raise and explore these issues from a university perspective.     

民族生留学生考试不及格原因与对策调查

为了解临床医学专业留学生和民族生较为严重的功课不及格的原因并寻求相应的对策，课题组于2005年12月进行了学生问卷调查，2006年4月对教师进行了半结构式访谈调查和访谈发现，学生的汉语水平和原有的学习基础、学习生活习惯、对学校教学管理制度和管理系统的熟悉程度、自学时间和学习努力程度、学校学院教师对待他们方式等是主要的影响因素；根据调查与访谈，课题组针对影响因素归纳出了相应的对策，